Medicaid Business / QA Analyst - Consultant

MSR Technology Group is seeking a Medicaid Business/QA Analyst - Consultant who will serve as a subject matter expert for Medicaid data and processes. The role involves performing quality assurance testing within a large-scale Enterprise Data Warehouse environment, ensuring the accuracy and usability of deliverables related to Medicaid programs.

Responsibilities:

• Interpret Medicaid data elements, business rules, and program logic for EDW initiatives
• Review inbound data from core systems (eligibility, provider, claims, managed care) for accuracy and mapping alignment
• Validate outbound extracts and reporting outputs for accuracy, timeliness, and format requirements
• Support development of data marts across eligibility, claims/utilization, provider, managed care, LTSS, and behavioral health
• Develop QA plans, scenarios, and test cases aligned to business rules
• Perform data reconciliation between source files and EDW target tables
• Validate transformations, aggregations, and derived fields
• Participate in User Acceptance Testing (UAT) with business stakeholders
• Identify data anomalies, mapping issues, and business rule gaps; work with data engineering and ETL teams to resolve
• Ensure referential integrity across eligibility, claims, provider, and plan datasets
• Define business data quality rules for ongoing monitoring
• Track and document issues in defect management tools
• Work with business stakeholders, vendors, and technical teams to validate requirements and deliverables
• Review BRDs, mapping documentation, and data models for accuracy
• Maintain QA evidence, testing documentation, and business rule records
• Support knowledge transfer related to Medicaid data usage within the EDW

Requirements:

• Strong Medicaid business knowledge (eligibility, claims, encounters, provider, managed care)
• Experience working with EDW environments, including inbound feeds, staging layers, integration layers, data marts, and outbound extracts
• Proficiency with SQL for validation and reconciliation
• Experience in data warehouse QA/testing, including validating data transformations and dimensional models
• Ability to translate Medicaid program rules into testable acceptance criteria
• Familiarity with HIPAA compliance and PHI guidelines
• Excellent analytical, documentation, and communication skills
• Experience with Medicaid EDW or MMIS modernization projects
• Familiarity with provider handbooks, policy documentation, or administrative rules
• Experience with managed care data (capitation, encounters, member assignments)
• Experience validating dashboards or reports in tools such as Tableau, Power BI, or Cognos
• Background in data governance or metadata management